Changing up your bicycle seat can help deflect ED risk

En español | Regular exercisers report fewer sex problems and more erotic enjoyment. But extended cycling — more than three hours a week on a narrow, banana-shaped "long-nose" bike seat — can cause erection impairment. Fortunately, cyclists can ride for any amount of time they like and incur a low risk of sex problems if they update their bike seats.

Think this is a modern affliction? Ha! As early as the fourth century B.C., Hippocrates speculated that the bouncing impact of long-duration horseback riding might cause erection loss. His observation was largely forgotten until the 1980s, when case reports appeared describing erection problems in healthy young men who had no risk factors but shared a devotion to cycling.

Researchers with the Massachusetts Male Aging Study investigated bicycling and erection impairment in the study's 1,709 participants. As time spent cycling increased, so did erection problems. Doing this activity less than three hours a week caused no erection impairment, but based on the cyclist's age, longer-duration cycling raised the risk 72 percent above normal.

As researchers focused on cycling-related erection impairment, they quickly realized that the problem was not cycling per se but the seats (saddles) beneath riders. When men sit in chairs the "sit bones" of the buttocks bear the body's weight. But because long-nose saddles are too narrow to support the sit bones, cyclists who use them compensate by putting their weight on soft tissue known as the perineum. This mashes down not only the nerves involved in erection but the arteries that supply blood to the penis. Nerve compression can numb the penis; arterial compression limits blood flow into the organ. Acting together, the two can impair erections.

Worse, over time, compression of the arteries that run through the perineum can trigger the development of deposits (called atherosclerotic plaques) that narrow them, further limiting blood flow. So even though superfit elite cyclists typically show few plaques in their other arteries, they often suffer significant plaque formation in the arteries between their legs.

As this problem became more widely known in the 1990s, cycling companies responded by widening bike seats, shifting the rider's weight from the perineum back to the sit bones. In one study 15 experienced cyclists rode for one hour on long-nose seats; a few days later, they rode the same length of time on wider saddles designed to put weight on the sit bones. On the banana seat, 79 percent reported numbness; on the wider one, that figure dropped to 14 percent.

Recently, researchers at the National Institute for Occupational Safety and Health tested perineal pressure, nerve function and penile blood flow in 90 bike cops in five U.S. cities. Thanks to the demands of their job, they were spending an average of 24 hours per week on long-nose saddles. The officers were then fitted with sit-bone-supporting seats, which they used exclusively for the next six months. Subsequent tests showed a 66 percent decrease in perineal pressure, substantially less penile numbness and improved erection function.

Another problem: Riders who tilt their handlebars down lean forward, which compresses the perineal nerves and arteries. To maintain good penile nerve function and blood flow, tilt your handlebars up, allowing you to sit in a more upright position. It also helps to ride standing on the pedals from time to time.

So far, research on this issue has focused on men. The female perineum, however, contains similar arteries and nerves. A recent study found that women cyslists who used narrow bike saddles and lower handlebars experienced pelvic-floor numbness..

These days, a large number of wide saddles are available. If you try one and experience numbness after riding, switch to another.

Michael Castleman, publisher of the website GreatSexAfter40.com, writes about sex for AARP.